Provider Demographics
NPI:1336687706
Name:BENTZ, NATALIE SIMCIK (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:SIMCIK
Last Name:BENTZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16116 CINCH DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-1613
Mailing Address - Country:US
Mailing Address - Phone:302-450-6987
Mailing Address - Fax:
Practice Address - Street 1:16116 CINCH DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-1613
Practice Address - Country:US
Practice Address - Phone:302-450-6987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111857235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist